Massachusetts Chapter of the American College of Surgeons

Back to 2021 Display Posters


Return to Sport or Work and Outcomes Following Arthroscopic Repair for Posterior Shoulder Instability: A Systematic Review
Antonio Cusano1, Alexander J. Ment1, Michael Groot2, Emily Curry2, Hussein Abdul-Rassoul3, Robert L. Parisien4, Brett D. Owens5, Xinning Li2
1University of Connecticut School of Medicine, Farmington, CT; 2Boston University School of Medicine, Boston, MA; 3University of Chicago Pritzker School of Medicine, Chicago, IL; 4Icahn School of Medicine at Mount Sinai, New York, NY; 5Warren Alpert Medical School of Brown University, Providence, RI

Background:
Posterior shoulder instability (PSI) accounts for 17.9% of shoulder instability. Arthroscopic posterior labral repair or capsulorrhaphy has shown improved outcomes, decreased complication rates, and accelerated return to sport (RTS)/work (RTW) for persistent pain or recurrent instability with minimal glenoid bone loss. This review evaluates the rate of RTS/RTW and outcomes following arthroscopic management for PSI.

Methods:
A PRISMA systematic review was performed. Included studies reported primary arthroscopic treatment of PSI with one-year minimum follow-up. Exclusion criteria consisted of non-English language, revisions/open procedures, anterior-posterior or multidirectional instability, and studies with fewer than ten patients. Reviews were excluded. Subgroup analyses were performed for all athletes, contact athletes, and overhead/throwing athletes.

Results:
Of the 1,504 screened studies, 30 (1,649 shoulders) met inclusion criteria. The mean age was 23.3 years (range: 12.4-65), with a mean follow-up of 35.3 months (range: 12-140.4). There were 1,051 males and 196 females. The mean ASES score increased from 51.8 to 86.8. RTS for athletes was 90.9%. 71.8% returned to their pre-injury level. Contact athletes were more likely to return to pre-injury level (78%) than overhead/throwing athletes (62.3%). 84.4% of workers returned to work. 89% of patients rated their shoulder stability as good/excellent. The overall complication rate was 1.5%. Subacromial impingement and adhesive capsulitis were most commonly reported. The overall rate of recurrent instability was 7.2%, with 5.2% requiring revision.

Conclusion:
Arthroscopic treatment of PSI restores stability, improves outcomes, and allows for a high rate of RTS/RTW with high patient-reported stability and low rates of recurrent instability/revision surgery.


Back to 2021 Display Posters